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Gonzalez AM, Mangine GT, Pinzone AG, Beyer KS, Townsend JR. Muscle Oxygen Saturation Dynamics During Upper-Body Resistance Exercise. SENSORS (BASEL, SWITZERLAND) 2024; 24:6668. [PMID: 39460148 PMCID: PMC11511377 DOI: 10.3390/s24206668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2024] [Revised: 10/15/2024] [Accepted: 10/15/2024] [Indexed: 10/28/2024]
Abstract
Research examining the changes in muscle oxygen saturation across multiple sets of resistance exercise is limited. The purpose of this study was to describe the physiological response of muscle oxygenation parameters during upper-body resistance exercise and examine the differential effects of relevant participant characteristics on resistance training performance and muscle oxygen saturation dynamics. Sixty-one recreationally trained men (n = 44; 21.8 ± 2.6 years) and women (n = 17; 20.2 ± 1.8 years) completed five-repetition maximum sets of barbell bench presses at a load equal to 75% 1-RM with a 2 min rest interval. Muscle oxygen saturation (SmO2) dynamics within the anterior deltoid were monitored using a portable near-infrared spectroscopy sensor. The percent change in SmO2 (∆%SmO2), the muscle oxygen re-saturation rate (SmO2RecSlope), and the highest measured SmO2 value during recovery periods (SmO2Peak) were measured. Two-way (sex [men, women] x time [sets 1-5]) repeated measures analyses of variance (ANOVA) were performed on muscle saturation variables. To examine the effect of relevant controlling variables, separate analyses of covariance (ANCOVA) with repeated measures were also performed. No differences were seen with ∆%SmO2 across sets. The main effects for sets occurred for SmO2RecSlope, whereby a decline was noted on sets 4 and 5 (p = 0.001) compared to set 1. Additionally, SmO2Peak was the lowest on set 5 (p < 0.001) compared to all other sets. Moreover, body mass (p = 0.013), diastolic blood pressure (p = 0.044), and mean arterial pressure (p = 0.033) for ∆%SmO2 were the only significant covariates noted amongst the muscle oxygenation variables. In conclusion, no sex differences and only a few set differences in muscle oxygen saturation dynamics were seen without employing any covariates. Body mass, diastolic blood pressure, and mean arterial pressure were identified as factors that could influence observed responses.
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Affiliation(s)
- Adam M. Gonzalez
- Department of Allied Health and Kinesiology, Hofstra University, Hempstead, NY 11549, USA
| | - Gerald T. Mangine
- Department of Exercise Science and Sport Management, Kennesaw State University, Kennesaw, GA 30144, USA;
| | - Anthony G. Pinzone
- Program in Exercise Science and Exercise Physiology, Kent State University, Kent, OH 44240, USA;
| | - Kyle S. Beyer
- Resistance Exercise, Physiology, and Sport Laboratory, Health and Exercise Physiology Department, Ursinus College, Collegeville, PA 19426, USA;
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Perrey S, Quaresima V, Ferrari M. Muscle Oximetry in Sports Science: An Updated Systematic Review. Sports Med 2024; 54:975-996. [PMID: 38345731 PMCID: PMC11052892 DOI: 10.1007/s40279-023-01987-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2023] [Indexed: 04/28/2024]
Abstract
BACKGROUND In the last 5 years since our last systematic review, a significant number of articles have been published on the technical aspects of muscle near-infrared spectroscopy (NIRS), the interpretation of the signals and the benefits of using the NIRS technique to measure the physiological status of muscles and to determine the workload of working muscles. OBJECTIVES Considering the consistent number of studies on the application of muscle oximetry in sports science published over the last 5 years, the objectives of this updated systematic review were to highlight the applications of muscle oximetry in the assessment of skeletal muscle oxidative performance in sports activities and to emphasize how this technology has been applied to exercise and training over the last 5 years. In addition, some recent instrumental developments will be briefly summarized. METHODS Preferred Reporting Items for Systematic Reviews guidelines were followed in a systematic fashion to search, appraise and synthesize existing literature on this topic. Electronic databases such as Scopus, MEDLINE/PubMed and SPORTDiscus were searched from March 2017 up to March 2023. Potential inclusions were screened against eligibility criteria relating to recreationally trained to elite athletes, with or without training programmes, who must have assessed physiological variables monitored by commercial oximeters or NIRS instrumentation. RESULTS Of the identified records, 191 studies regrouping 3435 participants, met the eligibility criteria. This systematic review highlighted a number of key findings in 37 domains of sport activities. Overall, NIRS information can be used as a meaningful marker of skeletal muscle oxidative capacity and can become one of the primary monitoring tools in practice in conjunction with, or in comparison with, heart rate or mechanical power indices in diverse exercise contexts and across different types of training and interventions. CONCLUSIONS Although the feasibility and success of the use of muscle oximetry in sports science is well documented, there is still a need for further instrumental development to overcome current instrumental limitations. Longitudinal studies are urgently needed to strengthen the benefits of using muscle oximetry in sports science.
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Affiliation(s)
- Stephane Perrey
- EuroMov Digital Health in Motion, University of Montpellier, IMT Mines Ales, Montpellier, France
| | - Valentina Quaresima
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Marco Ferrari
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
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Natera AO, Chapman DW, Chapman ND, Keogh JW. Predicting repeat power ability through common field assessments: is repeat power ability a unique physical quality? PeerJ 2024; 12:e16788. [PMID: 38282868 PMCID: PMC10812577 DOI: 10.7717/peerj.16788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 12/21/2023] [Indexed: 01/30/2024] Open
Abstract
Background The repeat power ability (RPA) assessment is used to test the ability to repeatedly produce maximal ballistic efforts with an external load. The underpinning physical qualities influencing RPA are undetermined. This study aimed to gain further insight into the physical qualities that determine RPA by analysing the association between physical qualities and an assessment of RPA. Materials and methods Ten well-trained male field hockey players performed an RPA assessment consisting of 20 repetitions of loaded countermovement jumps (LCMJ20), with a percent decrement score of peak power output calculated. Over a two-week period, each participant performed the YoYo Intermittent Recovery Test 2 (IRT2), a repeated speed ability assessment incorporating a 180° change of direction (RSA180), a 40-meter linear speed test (40 mST), an isometric mid-thigh pull (IMTP), a countermovement jump (CMJ), and a 3-repetition maximum half squat (HS) assessment. Pearson's correlation analysis was used to determine the strength of relationships between each assessment variable and the LCMJ20. The assessment variables with the strongest relationships within each assessment were used in a stepwise multiple linear regression analysis to determine the best predictor model of LCMJ20. Results RSA180percent decrement score (RSA180% had a very strong, significant relationship with LCMJ20 (r = 0.736: p < 0.05). HS relative strength (HSrel) was found to have a significant and very strong, negative relationship with LCMJ20 (r = - 0.728: p < 0.05). Stepwise multiple linear regression analysis showed RSA180 to explain 48.4% of LCMJ20 variance (Adjusted R2 = 0.484) as the only covariate included in the model. Conclusion The findings indicate that RSA180 as a repeated high intensity effort (RHIE) task is strongly related to LCMJ20 and is also the best predictor of LCMJ20. This may suggest that RPA can provide practitioners with information on RHIE performance. The variance between assessment methods indicates that RPA may be a distinct physical quality, future research should assess other physical capacities to better understand the factors contributing to RPA.
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Affiliation(s)
- Alex O. Natera
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
- Sport Science, New South Wales Institute of Sport, Sydney Olympic Park, New South Wales, Australia
| | - Dale W. Chapman
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Neil D. Chapman
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Justin W.L. Keogh
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
- Sports Performance Research Centre New Zealand, Auckland University of Technology, Auckland, New Zealand
- Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Yáñez-Sepúlveda R, Olivares-Arancibia J, Cortés-Roco G, Vasquez-Bonilla A, Monsalves-Álvarez M, Alvear-Órdenes I, Tuesta M. Association between Fractional Oxygen Extraction from Resting Quadriceps Muscle and Body Composition in Healthy Men. J Funct Morphol Kinesiol 2023; 8:149. [PMID: 37987485 PMCID: PMC10660468 DOI: 10.3390/jfmk8040149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 09/26/2023] [Accepted: 09/28/2023] [Indexed: 11/22/2023] Open
Abstract
This study aimed to associate body composition with fractional oxygen extraction at rest in healthy adult men. Fourteen healthy adults (26.93 ± 2.49 years) from Chile participated. Body composition was assessed with octopole bioimpedance, and resting muscle oxygenation was evaluated in the vastus lateralis quadriceps with near-infrared spectroscopy (NIRS) during a vascular occlusion test, analyzing the muscleVO2, resaturation velocity during reactive hyperemia via the muscle saturation index (%TSI), and the area above the curve of HHb (AACrep). It was observed that the total and segmented fat mass are associated with lower reoxygenation velocities during hyperemia (p = 0.008; β = 0.678: p = 0.002; β = 0.751), and that the total and segmented skeletal muscle mass are associated with higher reoxygenation velocities during hyperemia (p = 0.020; β = -0.614: p = 0.027; β = -0.587). It was also observed that the total and segmented fat mass were associated with a higher area above the curve of HHb (AACrep) during hyperemia (p = 0.007; β = 0.692: p = 0.037; β = 0.564), and that total and segmented skeletal muscle mass was associated with a lower area above the curve of HHb (AACrep) during hyperemia (p = 0.007; β = -0.703: p = 0.017; β = -0.632). We concluded that fat mass is associated with lower resaturation rates and lower resting fractional O2 extraction levels. In contrast, skeletal muscle mass is associated with higher resaturation rates and fractional O2 extraction during reactive hyperemia. The AACrep may be relevant in the evaluation of vascular adaptations to exercise and metabolic health.
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Affiliation(s)
- Rodrigo Yáñez-Sepúlveda
- Faculty Education and Social Sciences, Universidad Andres Bello, Viña del Mar 2520000, Chile;
| | - Jorge Olivares-Arancibia
- Grupo AFySE, Investigación en Actividad Física y Salud Escolar, Escuela de Pedagogía en Educación Física, Facultad de Educación, Universidad de las Américas, Santiago 8320000, Chile
| | | | | | | | - Ildefonso Alvear-Órdenes
- Applied Physiology Laboratory (FISAP), Institute of Biomedicine (IBIOMED), University of León, 24001 León, Spain;
| | - Marcelo Tuesta
- Exercise and Rehabilitation Sciences Laboratory, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Viña del Mar 2520000, Chile;
- Laboratory of Sport Sciences, Centro de Medicina Deportiva Sports MD, Viña del Mar 2521156, Chile
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Fasoula NA, Xie Y, Katsouli N, Reidl M, Kallmayer MA, Eckstein HH, Ntziachristos V, Hadjileontiadis L, Avgerinos DV, Briasoulis A, Siasos G, Hosseini K, Doulamis I, Kampaktsis PN, Karlas A. Clinical and Translational Imaging and Sensing of Diabetic Microangiopathy: A Narrative Review. J Cardiovasc Dev Dis 2023; 10:383. [PMID: 37754812 PMCID: PMC10531807 DOI: 10.3390/jcdd10090383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/21/2023] [Accepted: 08/25/2023] [Indexed: 09/28/2023] Open
Abstract
Microvascular changes in diabetes affect the function of several critical organs, such as the kidneys, heart, brain, eye, and skin, among others. The possibility of detecting such changes early enough in order to take appropriate actions renders the development of appropriate tools and techniques an imperative need. To this end, several sensing and imaging techniques have been developed or employed in the assessment of microangiopathy in patients with diabetes. Herein, we present such techniques; we provide insights into their principles of operation while discussing the characteristics that make them appropriate for such use. Finally, apart from already established techniques, we present novel ones with great translational potential, such as optoacoustic technologies, which are expected to enter clinical practice in the foreseeable future.
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Affiliation(s)
- Nikolina-Alexia Fasoula
- Institute of Biological and Medical Imaging, Helmholtz Zentrum München, 85764 Neuherberg, Germany; (N.-A.F.); (Y.X.); (N.K.); (V.N.)
- Chair of Biological Imaging at the Central Institute for Translational Cancer Research (TranslaTUM), School of Medicine, Technical University of Munich, 81675 Munich, Germany
| | - Yi Xie
- Institute of Biological and Medical Imaging, Helmholtz Zentrum München, 85764 Neuherberg, Germany; (N.-A.F.); (Y.X.); (N.K.); (V.N.)
- Chair of Biological Imaging at the Central Institute for Translational Cancer Research (TranslaTUM), School of Medicine, Technical University of Munich, 81675 Munich, Germany
| | - Nikoletta Katsouli
- Institute of Biological and Medical Imaging, Helmholtz Zentrum München, 85764 Neuherberg, Germany; (N.-A.F.); (Y.X.); (N.K.); (V.N.)
- Chair of Biological Imaging at the Central Institute for Translational Cancer Research (TranslaTUM), School of Medicine, Technical University of Munich, 81675 Munich, Germany
| | - Mario Reidl
- Institute of Biological and Medical Imaging, Helmholtz Zentrum München, 85764 Neuherberg, Germany; (N.-A.F.); (Y.X.); (N.K.); (V.N.)
- Chair of Biological Imaging at the Central Institute for Translational Cancer Research (TranslaTUM), School of Medicine, Technical University of Munich, 81675 Munich, Germany
| | - Michael A. Kallmayer
- Department for Vascular and Endovascular Surgery, Klinikum rechts der Isar, Technical University of Munich (TUM), 81675 Munich, Germany; (M.A.K.); (H.-H.E.)
| | - Hans-Henning Eckstein
- Department for Vascular and Endovascular Surgery, Klinikum rechts der Isar, Technical University of Munich (TUM), 81675 Munich, Germany; (M.A.K.); (H.-H.E.)
| | - Vasilis Ntziachristos
- Institute of Biological and Medical Imaging, Helmholtz Zentrum München, 85764 Neuherberg, Germany; (N.-A.F.); (Y.X.); (N.K.); (V.N.)
- Chair of Biological Imaging at the Central Institute for Translational Cancer Research (TranslaTUM), School of Medicine, Technical University of Munich, 81675 Munich, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, 80336 Munich, Germany
| | - Leontios Hadjileontiadis
- Department of Biomedical Engineering, Healthcare Engineering Innovation Center (HEIC), Khalifa University, Abu Dhabi P.O. Box 127788, United Arab Emirates;
- Department of Electrical and Computer Engineering, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | | | - Alexandros Briasoulis
- Aleksandra Hospital, National and Kapodistrian University of Athens Medical School, 11527 Athens, Greece;
| | - Gerasimos Siasos
- Sotiria Hospital, National and Kapodistrian University of Athens Medical School, 11527 Athens, Greece;
| | - Kaveh Hosseini
- Cardiac Primary Prevention Research Center, Cardiovascular Disease Research Institute, Tehran University of Medical Sciences, Tehran 1411713138, Iran;
| | - Ilias Doulamis
- Department of Surgery, The Johns Hopkins Hospital, School of Medicine, Baltimore, MD 21287, USA;
| | | | - Angelos Karlas
- Institute of Biological and Medical Imaging, Helmholtz Zentrum München, 85764 Neuherberg, Germany; (N.-A.F.); (Y.X.); (N.K.); (V.N.)
- Chair of Biological Imaging at the Central Institute for Translational Cancer Research (TranslaTUM), School of Medicine, Technical University of Munich, 81675 Munich, Germany
- Department for Vascular and Endovascular Surgery, Klinikum rechts der Isar, Technical University of Munich (TUM), 81675 Munich, Germany; (M.A.K.); (H.-H.E.)
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, 80336 Munich, Germany
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Scano A, Guanziroli E, Brambilla C, Amendola C, Pirovano I, Gasperini G, Molteni F, Spinelli L, Molinari Tosatti L, Rizzo G, Re R, Mastropietro A. A Narrative Review on Multi-Domain Instrumental Approaches to Evaluate Neuromotor Function in Rehabilitation. Healthcare (Basel) 2023; 11:2282. [PMID: 37628480 PMCID: PMC10454517 DOI: 10.3390/healthcare11162282] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 08/02/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023] Open
Abstract
In clinical scenarios, the use of biomedical sensors, devices and multi-parameter assessments is fundamental to provide a comprehensive portrait of patients' state, in order to adapt and personalize rehabilitation interventions and support clinical decision-making. However, there is a huge gap between the potential of the multidomain techniques available and the limited practical use that is made in the clinical scenario. This paper reviews the current state-of-the-art and provides insights into future directions of multi-domain instrumental approaches in the clinical assessment of patients involved in neuromotor rehabilitation. We also summarize the main achievements and challenges of using multi-domain approaches in the assessment of rehabilitation for various neurological disorders affecting motor functions. Our results showed that multi-domain approaches combine information and measurements from different tools and biological signals, such as kinematics, electromyography (EMG), electroencephalography (EEG), near-infrared spectroscopy (NIRS), and clinical scales, to provide a comprehensive and objective evaluation of patients' state and recovery. This multi-domain approach permits the progress of research in clinical and rehabilitative practice and the understanding of the pathophysiological changes occurring during and after rehabilitation. We discuss the potential benefits and limitations of multi-domain approaches for clinical decision-making, personalized therapy, and prognosis. We conclude by highlighting the need for more standardized methods, validation studies, and the integration of multi-domain approaches in clinical practice and research.
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Affiliation(s)
- Alessandro Scano
- Institute of Intelligent Industrial Systems and Technologies for Advanced Manufacturing (STIIMA), Italian Council of National Research (CNR), Via A. Corti 12, 20133 Milan, Italy; (C.B.); (L.M.T.)
| | - Eleonora Guanziroli
- Villa Beretta Rehabilitation Center, Via N. Sauro 17, 23845 Costa Masnaga, Italy; (E.G.); (G.G.); (F.M.)
| | - Cristina Brambilla
- Institute of Intelligent Industrial Systems and Technologies for Advanced Manufacturing (STIIMA), Italian Council of National Research (CNR), Via A. Corti 12, 20133 Milan, Italy; (C.B.); (L.M.T.)
| | - Caterina Amendola
- Dipartimento di Fisica, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milan, Italy; (C.A.); (R.R.)
| | - Ileana Pirovano
- Institute of Biomedical Technologies (ITB), Italian National Research Council (CNR), Via Fratelli Cervi 93, 20054 Segrate, Italy; (I.P.); (G.R.); (A.M.)
| | - Giulio Gasperini
- Villa Beretta Rehabilitation Center, Via N. Sauro 17, 23845 Costa Masnaga, Italy; (E.G.); (G.G.); (F.M.)
| | - Franco Molteni
- Villa Beretta Rehabilitation Center, Via N. Sauro 17, 23845 Costa Masnaga, Italy; (E.G.); (G.G.); (F.M.)
| | - Lorenzo Spinelli
- Institute for Photonics and Nanotechnology (IFN), Italian National Research Council (CNR), Piazza Leonardo da Vinci 32, 20133 Milan, Italy;
| | - Lorenzo Molinari Tosatti
- Institute of Intelligent Industrial Systems and Technologies for Advanced Manufacturing (STIIMA), Italian Council of National Research (CNR), Via A. Corti 12, 20133 Milan, Italy; (C.B.); (L.M.T.)
| | - Giovanna Rizzo
- Institute of Biomedical Technologies (ITB), Italian National Research Council (CNR), Via Fratelli Cervi 93, 20054 Segrate, Italy; (I.P.); (G.R.); (A.M.)
| | - Rebecca Re
- Dipartimento di Fisica, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milan, Italy; (C.A.); (R.R.)
- Institute for Photonics and Nanotechnology (IFN), Italian National Research Council (CNR), Piazza Leonardo da Vinci 32, 20133 Milan, Italy;
| | - Alfonso Mastropietro
- Institute of Biomedical Technologies (ITB), Italian National Research Council (CNR), Via Fratelli Cervi 93, 20054 Segrate, Italy; (I.P.); (G.R.); (A.M.)
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Lin TY, Chen JJJ, Lin LL, Ou Yang WT, Chen MY, Tsai YC. Effects of multicomponent exercise training on muscle oxygenation in young and older adults. J Exerc Sci Fit 2023; 21:138-146. [PMID: 36606262 PMCID: PMC9800305 DOI: 10.1016/j.jesf.2022.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 11/23/2022] [Accepted: 12/05/2022] [Indexed: 12/14/2022] Open
Abstract
Objective Though multicomponent exercise training was found beneficial in improving the physical functionality, the effects of multicomponent exercise training on muscle oxygenation are still unclear. The purpose of this study was to investigate the effects of multicomponent exercise training on muscle oxygenation in young and older participants. Methods In this study, 17 young adults (Y) and 18 healthy older adults (E) were recruited to receive a multicomponent exercise training for 12 weeks, 2-3 sessions per week. Muscle oxygenation, muscle strength, and electromyography data were collected and compared pre- and post-training. Muscle oxygen saturation (SpO2) during isometric knee extension tests involving voluntary contraction (VOL) and electrical stimulation (ES) was measured by near-infrared spectroscopy. The SpO2 kinetics in the contraction and recovery phases were calculated using a tangential model to extract ΔSpO2 and inflection time (IF). Results Muscle strength significantly increased in the post-training (234.31 ± 83.2 N·m, p < 0.05). The post-training ΔSpO2 of the ES in the Y (8.43 ± 5.35%) significantly increased and was higher than that in the E (2.78 ± 3.03%, p < 0.05). In the recovery phase, the post-training IF of VOL (7.07 ± 3.31s) was significantly shorter than that of the pre-training period (8.73 ± 4.46s, p < 0.05). Additionally, the median frequency of electromyography significantly decreased in the post-training period (103.84 ± 21.75 Hz, p < 0.05). Conclusion The multicomponent exercise training improved the muscle strength, neuromuscular performance, and muscle aerobic function irrespective of age. The primary adaptation of the muscles to the multicomponent exercise training between the two groups varied.
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Affiliation(s)
- Tai-You Lin
- National Sport Training Center, Kaohsiung, Taiwan
| | - Jia-Jin J. Chen
- Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan
| | - Linda L. Lin
- Institute of Physical Education, Health and Leisure Studies, National Cheng Kung University, Tainan, Taiwan,Corresponding author. Institute of Physical Education, Health and Leisure Studies, National Cheng Kung University, No 1. Ta-Hsueh Rd., Tainan, Taiwan.
| | - Wei-Tsun Ou Yang
- Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan
| | - Meng-Yu Chen
- Institute of Physical Education, Health and Leisure Studies, National Cheng Kung University, Tainan, Taiwan
| | - Yueh-Chang Tsai
- Institute of Physical Education, Health and Leisure Studies, National Cheng Kung University, Tainan, Taiwan
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